tv San Francisco Government Television SFGTV March 13, 2016 9:00pm-11:01pm PDT
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rediscovering of engine plus have our - and - >> thank you is there any additional public comment on that matter hearing none, public comment is closed. >> we can go into discussion my questions are there any issues you want to raise in terms of we have a record and pleasant attempts to reach out no compliance with the basic fundamental rules any issues or concerns around that you've noticed not gotten a came back back. >> yank from ti i don't know witness testified to those hearingsank i don't know from t
witness testified to those hearinnk i don't know from the witness testified to those hearink i don't know from the witness testified to those hearin i don't know from the witness testified to those hearini don't know from the witness testified to those hearin hearings. >> okay. do you want to testify when you sent the notice? >> officer brown speak spotlights microphone. >> march 3. >> march 3 what was that. >> that was notice was sent. >> and it is march 9 and then presuming it was sent certified mail. >> i'm sorry no no. >> so my question to the city attorney is clearly not there is a compliance problem but given the revocation is the most severe notice is that enough to take action on that item?
>> i would welcome commissioner mazzucco you're an expert around the rules. >> a couple of follow-up questions for officer brown you testified how long have you been trying to research the officer. >> since 2013 and humidities have you tried to reach officer andrew by mail. >> by mail. >> how many times are you reached out to him telling phonetically. >> he has a packager number so - >> and with reference to the rex regarding the special patrol officers they have a work a certain number of hours per month to be active and patrol specialize they have to have their own beat not a system to
this is your primary note. >> what beat does officer andrew have. >> have you received any information from the officers whether or not officer andrew has worked his beats. >> he's for the working his beat there's an issue of other people working for him. >> anything further you like and school board commissioner dejesus has a question. >> and i'm not saying you have to d anyone trial try to do a personal service on the officer. >> back in 2010, i spoke with sergeant at the time he spoke to andrew and said he was in texas and was operating outside of his
beat we haven't gone to specific where i sent the palace the new addresses was in sacramento. >> okay. >> anything additional. >> no, i'm comfortable. >> all right. sergeant do you want to call the vote on the motion to revoke special patrol commissioner president loftus i commissioner marshall commissioner, how do you vote? commissioner marshall i commissioner dejesus >> commissioner, how do you vote? i commissioner dejesus i commissioner mazzucco commissioner, how do you vote? commissioner marshall i commissioner wong commissioner, how do you vote? i commissioner melara commissioner, how do you vote? commissioner melara votes i say
motion passes all right. anything further on that matter thank you, officer brown sergeant, next lint item. >> item 7 adjournment action item colleagues a motion to adjourn. >> so moved. >> all in favor, say i. >> i. >> opposed? we're adjourned thank you, pu s ye>> good morning, everybody welcome to the san francisco board of supervisors budget and finance, subcommittee meeting,
for march 9th, i am farrell, and i want to thank, young, the clerk of our community, today as it was from sfgtv for covering this meeting. mr. clerk, do we have any announcements? >> silence all cell phones and electronic devices. completed speaker cards should be submitted to the clerk, items acted upon today will appear on the march 15th, 2016, board of supervisor's agenda, unless otherwise noted. >> would you call item one please? >> item one, resolution, authorizing the san francisco public commission to accept an award of up to $535,000 through the sfpuc's memo of understanding with the alameda county waste management authority, for implementation of our regional water conservation program, funded in part by grant funds from the california
department of water resources. >> thank you, and we have fusi to speak here. >> good morning, my name is johnson, and i am a san francisco, public utility water, conservation administrator. the sfpuc has been awarded $535,000 in the grand funds and we are going to be a ply /* applying those to the programs, and replacement of older fixtures here in san francisco is a fundamental component of the management. abag was awarded this granlt from the department of water resources of $32 million dollars, for the various drought relief, projects and entered into an agreement, with the stop waste of which we executed mlu and received, the grant funding for the replacement of the older fixtures on a reimbursement basis for the customer and today we are asking the committee to recommend to the board of supervisors to accept and
expend. $535,000 grant award and i am happy to answer any questions. >> thank you, colleagues,? any staff? >> mr. rose, could we go to your report, please? >> yes, mr. chairman, and members of the committee on page 2 of our report, we note that the proposed grant requires that thepuc contributed the matching funds of $384,195 and their budget, of 15/16, includes, 2.5 million, and as previously appropriated by the board of supervisors to pay for the high efficiency, rebates, which thepuc will use as the source for the $385,000 in the required matching funds and we recommend that you approve this legislation. >> thank you, any questions for the budget analyst? >> okay, we will move on to public comment, anybody wish to comment on item one? >> seeing none, public comment
is closed. >> a make a motion to approve this and send it to the full board. >> we can take that without objection. >> mr. clerk, would you call item two? >> item two, resolution approving the issuance of the tax exempt op bli gageses by the california state wide, communities not-to-exceed $16 million to be owned and operated by the california college of arts or afill ate. >> we have the office of public finance to speak. >> good morning, members of the committee i am from the controller's office of public finance, i have from the applicant, from the california college of the arts mr. ken tanser. >> background. the tax equity and responsible act, allows the tax exemption of interest on the certain types of debt, through the community,
development authority. and this is a joint powers authority to which the city is a participating member. and the authority issued bonds, and notes and other forms of indebtedne indebtedness, on behalf of the organizations such as the amply can't, and the college of the arts. and federal tax laws requires that the governing body, in which the project is located approve the financing and after previeding opportunity, for the hearing before the bond committee on the tax exempt basis, and the jurisdiction is not object mri obligated. a hearing was held, on february 10th, no comments from any of the members of the public were received or heard. the amount of the bond assuming all required approvals are obtained. the authority will issue, an amount, not-to-exceed, $16 million. on behalf of the california
college of the arts, bond council on the transaction. the purpose of the project is to pay, and or reinbers the corporation, for the construction and improvement and equipping and lease and acquisition of property, 150 uber street in san francisco and to finance or refinance, the con trucks and the acquisition, improvement and other expenditures at other facilities at 11, 11, 8th treat, and 450 irwin and all in san francisco and to pay for other related costs for the project. this approval of this legislation will have no fiscal impact to the city and council of san francisco, and background on the borrower. the california college of the arts was founded in 87 and offered majors in the area of fine arts and design and write and have 1950 students enrolled,
the project in the district ten and the legislation by supervisor, coen. >> thank you very much, colleagues, any questions for the office of public finance. >> okay, seeing none, mr. rose we do not have a report for you on item two and we will move to public comment, anyone wish to comment on two? >> seeing none, public comment is closed. a motion? >> move it to the full board with a positive recommendation. >> movement fspurpt yee. and without objection. >> would you call three, please? resolution, to accept a grant in the amount of $750,000 from the united states department of justice office of violence again women, in the teen pilot project. >> thank you very much, we have the individuals from the
department to speak. >> good morning, chair farrell, and supervisor tang and yee. i serve as the grant's manager at the department on the status of women. i am here to give a brief overview of the exciting opportunity that we have to pilot a domestic team, as part of a three year, federal department of justice, grant of $750,000. and as you know, domestic violence is a serious problem in san francisco. according to our family violence council's report, 911 receives over 8,000 calls related to domestic violence, every year. the district accounts for one of the highest call volumes and also it has exceptionally high rates of family violence, at 1.7 times the average rates city wide according to the district attorney office. several domestic violence victims are at risk of being killed by an entity mate partner, at least a third of all women murdered in the u.s. are
killed by an intimate partner, these national statistics warn us of the persist ans of this issue in our own city and especially in our neighborhoods like bay view that report, high rates of family violence. that is why, in this grant, we are offering with the bay view, ymca to pilot a high risk team in collaboration with the district attorney office and the police department and glide. this is the first time we are partnering with the bay view, ymca, the madres will be supporting this at the ymca with the technical and assistance, and the case management, and the glide through is to insure that these services are delivered in a competent manner. >> specifically, over the course of the three-year, grant. our department will receive, $20,000 to manage the grant over all. and the district attorney office will receive, just about
$400,000 to staff a prosecutor and a victim, advocate, the police department will receive $115,000 for partial, staffing of to develop the web base the danger assessment smart for an application to identify, high risk, victims. the bay view, ymca is allocated $90,000 to provide a part time staff to screen, and for the clients, experiencing domestic violence, who access the center there. madres will receive, $15,000 to fund a program director and a case manager to support the bay view, ymca and finally the gliend foundation is allocated about, 43,000 to provide case referrals and cultural competent, technical assistance to others. this grant will build, the capacity among our community, partner to better serve the victims in relationships and to improve the law enforcement
ability to bring the batters to justice, this extend resolution, request is retroactive to october, first, 2015, when the grant was first announced. there was staffing changes of the department and i was brought on in january to manage the grant. and the federal government has not yet released the funds. but we know that the money is coming and we will ask for a no cost, expansion for the end of the grant to insure that they are making full use of this award. we request the budget and finance committee to kindly approve the resolution. and before icon include, and let you hear from the grant partners i want to recognize the leadership of cohen and her staff and thanks, also to laro bush in the mayor's budget office and to harrison and in the district attorney office for the technical assistance. for this request. on you are partners from around the district attorney office and the police department are here to share a few words of support.
thank you. >> thank you, supervisors, thank you for the opportunity to say a few words. we are very proud to be part of the multi disciplinary team, the homicides p effect, xhirn and communities and all of us. and we want to do better. domestic violence, homicides are predictable we know from a lot of national models, we can look at victims and identify who is risk factor and see who is high risk and we know the high risk factors we can do better to protect them. ult maimately we will be able t identify the high risk victims and enhance the service and response and improve safety for them and the community. so we ask you to please, accept the accept and expand, and help us get this grant so that we can work better for the citizens of san francisco. thank you. >> good morning, supervisors,
ladies and gentlemen of the committee. my name is santos and i am the lieutenant in charge of the special victim's unit. today i am here in support of the grant that presented to you and i want to talk to you about domestic violence. >> every day there is an act of domestic violence, some are minor, most are more serious, and sometimes, they are often, fatal. the san francisco police department has an ongoing commitment to people that are involved in domestic violence incidents. and to reach that goal, of commitment, we work with a lot of the community-based, organizations. we reach out to the department of status of women. and the domestic violence council, the san francisco, district attorney's victims assistance programs, the madres and glide and others.
>> to give you an idea of what it is like for an officer to respond to a domestic violence scene, and an officer, often walks into an emotional charged incident where they have a lot of tasks before them. number one, is tending to the injured parties. finding out what happened. securing the safety of those involved. providing resources for the victim's survivor and then preparing an incident report for the incident that occurred. it is a large task when you think about what our officers have to deal with in a short amount of time. and highly charged incident. our work with our community-based organizations and our partnerships, has helped us, identify our best practices in resolving these types of situations. they have done an outstanding job, in providing commitment both ways to resolving and
hopefully ending domestic violence, one of the big things that would be helpful for us with this grant is supporting our staff, with additional domestic violence investigators. and an application that will help officers have a checklist of what they should be looking for in a domestic violence situation. so that when they write a report, and it is submitted to the office of the district attorney, for the prosecution, we have the situation, where we are not only do we help to speak for the domestic violence, survivor, but we also help that we can educate the batterer in this situation, so that when they rehab tat, they will have a better future, so i am asking, all of that, you support this grant. and i look forward to at some point coming again to share our results of positives in this. >> thank you. >> good morning, supervisors.
and commission. my name is cherise and i am the director of the family support services at the ymca. and this grant for us, although a pilot, represents a significant shift. we have been engaged in this work, serving survivors and we know that this is no -- this work is significant. and it is large. and for us, what this opportunity represents, is not only a chance to continue to deepn and extend our work but to work in meaningful partnerships, we have been present on the service end and working with lacasa and glide will support our capacity but really what it is this about the intentional collaboration with the police department and the district attorney office. and we believe that this pilot, will significantly enhance the safety, that families receive. the bay view, hunter's point has a high degree of family violence.
and stress that gets associated with these situations and so part of what we honor is that this work, this collaboration is essential to really not just offer a temporary sort of ban aid solution but to increase the family's sense of capacity. and when you have a team, that is going to not only support, families and receive services, but really help to up hold, the perpetrators accountable, and it can make the longer term shifts. so we ask that you support this pilot. and we thank you for your time. >> we kind of blended in the public comment, i want to make sure that if we have the chance to have any questions for staff? >> again, no report, and so supervisor yee? >> we don't have a budget analyst report on item three. so supervisor, yee if you want to comment or staff? >> no. i just wanted to say that i am fully in support of this grant
and i want to show my appreciation for the department of the status of the women. in what they do in dealing with domestic violence. it is an issue that has been around forever. and we need to do better. and by working in the community, and i seen a lot of cases where there was not any support, and it is just happens over and over again. and so, thank you very much for your work. >> we will move to public comment. anyone wish to comment on item three? ♪ >> life -- is going nowhere. ain't you. >> run for the city shadows. run for the city shadows. in these golden years. i believe oh, lord, i believe
all the way ♪ run for the city shadows. stick with your city for 1,000 years, thank you for this grant. and it brings back or pulls back the tears. thank you. >> anybody else wish to comment on this item? >> seeing none, public comment is closed. colleagues, any questions or motions? >> through the cherry would like to make a motion to send forward this resolution, with a positive recommendation and we can take that without objection. mr. clerk, would you call four? >> resolution of the san francisco agency to execute industrial lease agreement with tanforan llc for 7.3 acres of space located at 30 tanforan avenue in south sfa, to be used for the bus operating training courses for nine and one and a
half year term with the initial annual base rent of $2.48 million, and the annual 2 percent rent increase. >> okay, thank you mr. clerk i am a creature of habit. thank you for being here for this item. >> thank you, good morning. mr. chair, and members of the committee. ed reskin director of transportation and i appreciate you giving us the opportunity to return to cover this item, which is one that i understand is a significant one. it is extremely important to us. which is why i am here. and joined by the agency's transit director and hr director and training director and real estate, manager and numerous of others, including the controller's office, as well as representatives from the transport, local, 258, who represent the operators and we are all here because we know that this is the significant
item, for you to consider as it was for my board and me to consider. it is one that we really feel is critically important. to our ability to continue delivering more, reliable and more safe, and more cost effective muni service, to everyone who rides muni, particularly those who are most dependant on it. i appreciate this being budget and finance committee. that there has been a lot of focus and scrutiny on the cost of this proposed lease. and that is, fully justified and we thank the budget analyst for their good work, with us on this. there is no question this is not an insignificant cost. there are, however, a number of indirect costs that we are experiencing today. and fairly significant opportunity costs, that we are missing out on as well as benefits. that we think we will be able to
achieve with the facility that this lease would provide for us. and it is only with a very, exhaustive review, and weighing of those costs and benefits, that i bro ut brought this item to the board and now to the board of supervisors for your consideration. i will say, as a person that is charged with developing and presenting a responsible, sustain able budget for the agency, expenditures of any kind, are ones that i scrutinize very carefully and before i bring someone forward i need to make sure that it is going to advance the best interest of the agency. and i get that every dollar that we spent on supporting services such as training, or in this case, a facility for training, it is a dollar that we don't have available for direct service and it is something that we weigh very heavily, but,
what we are trying to do is not repeat the mistakes of the past. and we are in a situation right now, where we do have a budget to bag, as the city does. and one in which some of our expenses are rising faster than our revenues, that is driven in part by the labor costs by pension costs but it is also driven by some policy decisions that we made. for example, to forgo some revenues to make sure that more people can access muni or to invest, more heavily in the main ens of the equipment and right now the expenditures on the materials and supplies are happening at a faster rate than ever before and that is a good thing because it means that our mechanics are doing, preventive maintenance on the vehicles that are presenting in more reliable service and likewise, we are
spending a lot of funds in the training to catch up and close the gap on the operator shortage, which is also, relating in more reliable service. so these are and in the past, muni had not been investing at maintenance at the level that i think that we need to do and i think that this lease will provide us a training facility is an important part of our sustained ability to deliver a better more reliable, and more cost effective service and again i would not have brought this here if i didn't fully believe that. i get that you know, we would have loved to see, a lower costs, you know, lease in a different location or an opportunity to purchase land but as you know and you have seen this in other items that have come before the budget and finance committee, and the real
estate market san francisco and in the bay area is challenging and to find the space for a training facility, is all the more challenging and i believe that our staff has done very diligent, work to bring forward, the best possible agreement given the larger economic situation to secure all of the necessary approval and to negotiate a fairer price for today's economy that is why, that i recommend that this lease to you, for your approval. and i guess that what i would just say in closing, before i turn it over, for john, our transit director, and others, to try to aaddress some of those other indirect costs and opportunity costs and benefits, more specifically, just, i want to say, that, or remind you, i guess, that to the extent that we are not able to deliver service, because we have not
been able to train enough operator as it has happened in the past, but to the extent that we have a bus that is disabled because of a prevent able collision and what happens we have not been able to offer as much training as we would like to do. and it is the muni riders who are impacted. and particularly, some of us have choices about how we get around and if muni, is not working and we cannot afford a taxi or a bike and we have a car that we can drive, it is those that are the most transit dependant in the city that are the most impacted by our ability to consistently, provide safe and reliable and cost effective service and so that is also part of our calculation for bringing this forward to you today, thank you for giving us the opportunity to walk you through this lease, and we have a lot of folks here able to answer any questions that you have and at the end, i would strongly, and
respectfully, urge that you do forward this to the board with positive recommendation and so thank you for your time and i am going to turn this over to the transit director, john haily to walk you through and address the questions that were raised at the last meeting. >> good morning, and thank you again for the opportunity to provide additional information. and also thanks for the budget analyst for including the material that we submitted as part of of their review as i will focus in the interest of time on the questions that were raised the last time, but just for a couple of brief moments to under score some of the introduction that mr. riskin gave this has been in terms of providing the service as well as
operators and training the mechanics is very much an essential and a key function and as i will walk through with you over the years, the inability to provide the level of service has had a negative and a costly impact not only on the direct provision of service, but on our costs and over all, in order for us to deliver the kind of service and both the current and the expansion it involves making sure that we master three key variables. one is the staffing and as we have talked about before, the staffing level, we built up, as we will talk about with the training and we had the new management in place and we reviewed the curriculum and so we feel like from the staffing side, we made progress and the vehicles and with your help and support. and we brought on new vehicles and we continue to do so, over the next several years. and that will in fact not just increase the training burden, not only for the operators but for the mechanics but it will
change it dramatically as we work with the other city agencies to change the nature of the workforce, in order to take care of more sophisticated vehicles. the third leg of the stool, if you will, which is what we are focused on today is the facilities not just the facility for training but all across the system, we are the product of old facilities, undersized facility and we are continually looking, with your help and support to improve, and right now, we feel that we can demonstrate and we have made, significant progress on two of these three variable and hopefully, as i have said, with your help and support, we can make progress on the third. directly, to your questions that were raised last time, about the specific costs of training, i came here last time, and i mentioned to you that i, and we had missed two classes. and we in fact, have missed one. so, i stand corrected. in that. and that fact.
as i will go on in a moment, we have also, reschedule every one no the last year and that in turn has an additional cost and i think that the important message on this particular slide is the over time cost in what you can see is the drop in over time, and that is the result of having enough operators to meet our schedule service and the cost of a missing class and we have provided the back up detail, is approximately, 415,000, now that is direct cost in terms of the service that we would have to provide, by having enough or not having enough, operators on the street. just to point on the next one, on missing-the service and while, five percent may not seem like the significant number, i would, and it is something that we have worked very hard, and it is the essential to providing the transit service and to put the skeled service on the street and so we, putting out all of
the runs is our goal and 100 percent every day and we are getting close to it and we need a proper training and we need to keep the pipeline filled in order to do that. and if you notice the difference between 2014, and 15, just to highlight one day on april 11, 20 is 4, we missed 5 percent of the service and that is about 60 or so what we call runs, and i don'tn and i don't expect that any of you remember that particular day, but i think that if you will go back and look at your full minds in your office may have been busy but by missing some of these 65 runs on that particular day, we had things like on the 57 line. we had a 40-minute, gap in service on the mline, we had a 20 minute, gap in service that related in the crowding and the slowing of the subway system. on the m, line we had overcrowding and a gap. and so, my point is that the impacts of missing service, grow
far beyond the direct, dollar for dollar cost that we talked about before. also in terms of your questions, the classes per year and you can see the chart that we provided and as i mentioned one class was actually cancelled in 2015, but all 13 were schedule and reschedule, multiple times for a video of reasons. particularly, on the facility availability. and that is key to planning, planning transit service should be very predictable and we have a schedule and we know that we have to provide the schedule every day and we know the vehicles that we need and we need to get them ready and out there. not having a facility, to properly plan our training programs for the impact of that. and in terms of the options we walked through last time, a number of options that we looked at is we said, this is an
odyssey that has gone on over a period of some 15 years, and look for a new place, no training facility and we are down to basically two, that we can get, periodically at the moment, and of the list that we showed you before, this is not a new issue for us, as it is a problem that has plagued the agency for several years. in 2013, the controller's office, reviewed and made a recommendation that you see here.
of, and allow us to stream line, the classes and make them more efficient right now, because of constraints in the existing facilities and if you go to some of the facilities and you can see the maintenance people putting up a board for a couple of hours and take it back down and they have to start over again, tomorrow it is an inefficient and a costly process, and so having our own dedicated training facility will have a number of benefits here is an example of the other kind of training that we can do, operators, and again, the, and we focused on the new operator training, our operators are professional. and they are governed by a series of legal, and professional requirements, they require, annual recertification, and we could also, train our other groups in there and we have the non-revenue vehicles such as the overhead line trucks that could also benefit from being trained in the location like this. so the purpose and the value of this facility, while we have focused on the benefit for
direct service provision will also go to the functions within the transit, that support that, and in terms of the lease, this is or has not changed, and there was an adjustment made in the analyst report, and there is simply the cost, again of missing one class, directly related to having to kill those runs, or what we call runs at over time, on a particular day, and due to no operators. and again, as we have said and as mr. riskin pointed out, over a number of years, we have looked at a number of options, and the potential options are dwindling, and quickly. and so, we feel that if we do not move forward on this facility, that without, without over statement, it does jeopardize our ability to deliver the high quality of standards in service that we have come to expect as well as
to meet the future service demands, in march of this year and early next month, we will do the fourth service, increase. and we are very pleased to be aible to do that. and we and one of the reasons that we can do it is because of the effective training that we want to be able to keep able, and keep doing that. and so, in finally, again we ask for your support for this, and it is critical to the essential provicious of transit services and of high quality and safe and reliable service and we appreciate the opportunity to clarify the previous questions and i am here and as mr. riskin said there are otherwise from the agency to respond to your questions, thank you for your pashgs /* pashgzpatience. >> thank you. supervisor yee? >> yes, i really appreciate you
valuing and having enough drivers out there, that are probably trained. but i am just looking at your notes, that were given to me, and i just curious, you say that you, and you say that, one class in 2015, was cancelled. and 13 were provided. what was the cause of that cancellation? was it because of in the past, previous years, it seems like the number of classes that were available were limited to how many trainers you had. so, it was consolation due to not having enough trainers? >> but in the case of cancellation, i think that it was related and it was a resource, constraint, related to the number of trainers, and so part of what we have been doing over the last several years and working on the staffing level. so he that that, and there has been a substantial investment
that we have made in getting the right number of trainers and getting the new management in the training program. but the cancellation and in this particular case was due to absence of trainers, and we have, and excess of training demands. >> and have we ever, missed or sorry, have we ever, cancelled a training due to not finding a space? >> no, we have, as the our response indicates, and last year, all 13 classes potential classes were adjusted, and sometimes, multiple times, due to the limitations of the facilities. and that is of course, the direct cause that we talked about, but also the burden that falls with going through with having adjusted in the service and even, adjusting the hiring pipeline, which can be very difficult in this city. >> and then, and then, i also, noticed that, even though you mentioned that one class was
cancelled, that last year, over time? was small for several years. and so where is the correspondence, because you mentioned the argument that by missing or cancelling a class, over time is going to be driven up 5 million dollars and we missed a class last year, and actually, the over time was 900,000 verses almost, 7 million was the year before. >> well, the over time is down, because we have over, and the last for you years in particular, we have increased the training through put and we increased the number of classes or the number of operators. and so, the over time is down over all where it is never going to be zero on a particular day because there is always going to be days that we use, 15 to 20 pieces of work in over time, so being able to reduce the over time, is a function of having
enough staff, having them train through there. and so that is how we were able to row dureduce the over time, we failed to have a facility, it is a very, and what i would say that it is a tenuous proposition, because if we don't and if there comes a time when as the number of potential options is widled down and there are two and the options are limited. and we pull together a handful of times around other events and the simply, with alameda. and so the point, to get to here, and say, well, we have not cancelled yet, primarily for the facilities, the longer it goes on, the higher the risk and clearly the impact for us, and it is very great. if we do have to do that. >> and just one last question. just looking at these numbers. for last for the calendar year, 15, there were 13 classes and then you are planning for 2016,
9 classes, is there a reason why we are reducing the numbers of classes from 13 to 9? >> yes, sir, there is. what we had over a period of years, developed a backlog of shortages that was this 5 percent, and that you were seeing, and so we built it back up. and so what you have is on a pip cal month, you have 15, on average, 15 operators who are equipped to relieve through the attrition to leave the agency. so what that means is that you want to have, like an ideal class size and say 30 and so you want to have the series of classes, of 30, and you can, once we have caught up on the backlog, you know, and so that we are in a, a good situation so that we have, actually have the operators, so if we have the, or a bad day or sick, and have to extra service we can do that.
that is why the classes should be ongoing and constant and it is critical in terms of our planning for service. because we know, given the agency's history that every month, 15 operators will leave and they need to be replaced. if we don't replace them, then their work will have to be replaced at over time or cut the schedule, and we are hopefully going to continue in the future, with your help, and support to be in a growth period. >> in 2015, when you had 13 classes of training. how many, facilities were you using? for 2015? two right now? >> that is correct. now we are down to nine and we
have caught up and i assume that, going forward, you will continue to have nine or ten to keep up with the attrition? >> that is correct. >> so that is what we need to keep up with the attrition. and the service that is coming in april, and that means that we will be adding additional operators that will be in the training as well. and the other part of the training, is not just the training but the annual certification and the training and retraining after someone has an accident, all of those kinds of things that we need to do. and okay, i, and i, and this, there is nothing else that i can ask. >> okay, supervisor, tang? >> thank you. and i am going to repeat a little bit of what i said last time, but i completely
understand the need for adequate, training for facility and having the stability that you are seeking and i want to extend my appreciation for the operators and that is what makes our service run. and so, i get that, and i think that we are just trying to sort through and reconcile, you know, again, this enormous jump in price. and i think that i would be more comforted if i knew that at the end of the term that there was more stability after that and the fact that it is daily, city or san francisco, and that, there are zoning controls that would not, and come into play, in some way, to prevent you from continuing, and so i think that that is what gives at least, i think, most of us, some pause there. you said that in the class that was cancelled in 2015, was not due to the lack of facilities or the lack of trainers, is that an
issue that mta is working on addressing then? as i said, one of the things that i said to deliver the service, effectively, you have to have the right staffing for the training which we believe that we have, and you have to have the vehicles, which we are working on, and in that picture, that continues to improve and you have to have the facility. and that is why we are here today. but, no, we feel that we have made, substantial progress in terms our equality, and the quantity of our trainers and as i said, we are reviewing all of the curriculums and all of the rubrics and the machi manuals a they will be adopting and changing as the new vehicles come in and we made the changes to the system.
so the training will be a constant need. and it is very much a core, and critical function to transit. >> i mean, how many trainers, you mentioned there is a lack of trainers, and so, what is mta's plan in terms of making sure that you have enough trainers so that you don't have to potentially cancel classes? >> i am sorry, if i was not clear, we do not have a shortage of trainers now. >> okay. >> we have two years ago, and we have rectified that by hiring more trainers. there was -- chl >> i believe in the last year as well, all of the classes had to be reschedule as well was that due to facility issue or trainer issues? lack of availability? >> it could be a number of things part may be the dates for the facilities, because with the planning you want to be able to
say that we know how long it dates and if the site is not available, and then we have to go back and look at the pipeline for the training. >> and so are you saying it was a combination of both then, for the ones that were reschedule? >> good morning, supervisors, sorry to interrupt, i am the director of human resources there are a couple of questions that i can answer. we have to 55 and so there is no shortage there, and in 2015, we had one facility that we have offered. that we are not sure about. >> okay, did you have information, also about just again, it was just to confirm, it was a combination of the lack of trainers, or lack of facilities, when we had to reschedule all of the trainings in 2015, or was it just the facilities. >> we are rescheduling the facilities and the timing issues, is that we had to go to saturday and we worked from
eight hour days to ten hour, training days because we had the facility issues so we increased the over time to the trainers to 8 to 10 hour days, and had the change the skeldz and go to weekend. >> okay. >> and then, just remind my again, how many operators or new operators are going through each of the classes? >> we are average about 30. in 2015, we were getting the job and spoke to increasing the amount of operators, and we were shooting for, i think that we averaged about 40 something in 2015, even with the 13 classes we were doing 40. per class. >> okay. okay and then, you know this is a question that i would ask the staff internally, and i think that for the purpose purposes i think that it would be good to explain as well, the lease that we have before us today is for 9 and a half years. and has mta considered maybe, shorter term lease? not that again that we want you to not have stability, for long
term and operators, but i know that this was a cost and there is uncertainty passed the nine years. >> good morning, real estate manager to address the lease, it is a 9.5 year lease, it is a 9.5 gross industrial lease, and industrial properties are diminishing throughout the bay area. we are at the mercy of two properties right now. those two properties are the cal palace, and the city of alamena air strip field if you will. those properties, there is no reassurance, whether or not they are going to be available throughout this 9.5 year term of the lease, none whatsoever. the lease for us, in fact, is a very pro-active approach to at least get ahead of our training curve and make sure that our new operators are trained consistently and that we do requalification and all of the other aspects of training necessary in order to provide a
consistent, ongoing program in a facility that will be provided to them for their use, on a very, consistent level basis. this lease, the lease is market. the lease is at market, and if not a little bit below market. the landlord, and the developer, if you will is going to put in 11 million on improvements to prepare the site for us so that we can have the dedicated training facility, for 9.5 years, and the reason why, the lease is not going to be or should be reduced or could be reduced to 5 years, for example, is primarily, because the landlord, is putting in this 11 million in improvements needs to get financing from a lender. well a lender is not going to lend on a lease, for 5 years at a rate of say, 2.5 million dollars on average per year. because, over the term of 5 years. that would be completely ex-spended out. and so in essence, they are not
going to do it because it is risky and the landlord is not going to make any return on the investment and so this is a fair lease within this market place. and that is the reason why. we could not reduce it down to five years. >> thank you for that. >> in terms of the alternative sites that you had considered over the previous years. most of the reasons cited for why we can't go with them is because they are not consistently available. and so has mta thought about entering into agreements with any of these sites to lock down certain dates for training? >> that is what we try to do. that was our original approach and that is something that they are not willing to do for us. they typically reserve the sites for the other uses and the mta, is not, the type of use that they are looking for, on their tech properties. and it is a type of use that is zoned for this property in san francisco, and this property of this nature, of this size, we need a size site, and it needs to be between five and seven
acres that is exactly what it is. these other, these other places that we looked at and exhaust syphiliv ive list, they are not willing to give us a license and lock it down for a consistent period of time, because often times we are not in the court business or the type of lesson that they are looking for. typically, one of the reasons why, is because our buses over a period of time with training, they end up tearing up the concrete surface of the parking lot, what we end up realizing as a result of this is that we get bills back, that have to pay to fix their parking lots. why is that the case? because they are not improved to accommodate the type of service that it agency needs for its buses. what our property owner is going to do is going to build, a 7 inch concrete, base supported by
rebar that is going to give them the facility to train, and the other locations no. there is an indirect cost and that is one of them. >> as i said, earlier i think that we all need to recognize the need for this and the discomfort is what is going to happen after nine years, he cannot predict that obviously. and we will not be here. but, i appreciated seeing the cost break down in terms of what the, and we just saw that it was what you were spending, 100,000 on the rent for your two leases. >> license fees. >> right now. >> for the two sites. >> that is correct. >> but, clearly there is other costs associated with not being able to have the predictability of the facilities and being aible to get the operators out on the roads and trained. so, i appreciate that additional detail that was sent, and i think that for me, that would probably be the biggest justification, for supporting something like this. and i mean that if we could have
found another alternative and i would have said, go for it. i personally don't see one at this moment. unless there is something else that you want to share. >> there is nothing else. that is why we are here today. >> so, i mean, i think that again, not fully 100 percent, comfortable, but i think that today i could see this going to the full board. >> during the term of the lease also we are going to work with the city of san francisco to do our best to extend that development agreement. we will do that. as part of the process. and at the same time, we will also continue to keep our eyes and ears open and look for alternative sites. >> supervisor yee? >> yeah. as a quick question. if you are to be able to lease this property, i'm assuming that you won't be using it year round? with the nine or ten trainings a year? has there been any thought about
subleasing it when you are not using it to offset the cost. >> yes, there are nine to ten training schedule up coming and in the past, what i understand on average if you will. but that is new operator, training. so, i am hoping that the training program can expand their efforts and use this as additional training for all of the different aspects that are involved in the training program, whatever it might be. and in terms of doing some kind of subletting or some outside leasing, the lease is flexible just like the option of the lease it is flexible and so, the potential is there. yes. to do something like that. the potential is there to exercise the option of the lease to buy the property. but that is only going to be done if it is financially feasible for the agency to do so and reasonable because we have to work with the city of south san francisco and see whether or not this is investment that we want to make at the time.
so, getting back to your question. what we would have to do because it is approved the use permit, or the conditional use permit associated with this property and this project. we would have to work with the city of south san francisco and see if they could, allow us to do some form of other type of use, because we don't know what that use is. right now, they have approved what we are presenting here today. >> i really was not thinking in terms of other use, but i, and without knowing the situation, from the other s, and there were the bus systems and transit systems, and i am just thinking. >> we are aware about the 7th largest transit agency i believe. >> and so the question will be, if there are other municipalities that need the training space for the bus drivers or truck drivers or whatever. >> all of the transit agencies have dedicated training space for their operations. >> okay. >> any further questions?
>> just for the record? >> just, if i could add, just clarify, first of all, i think that the needs of our own training department not just the new operator training but the ongoing, training will consume a pretty significant amount of the space and time that this facility would make available. that said, we do think there are opportunities elsewhere, even within the agency, we have talked to ourpara transit provider. and who thinks that there may be some use that they could get out of this facility, and so that i think that there are opportunities for us within the bonds of the current agreement for us to leverage this, if not with other transit agencies which as he and they mostly have their own facilities but the others that we work in the city and the other city agencies and we think that potential is there and adjust our operating training alone, new and ongoing training will consume a great proportion of the time and space, that this lease would
provide. >> thank you. >> thanks. okay, mr. rose. >> thanks for hanging in there. and can we go to your report. >> and yes, mr. chairman, and member of the committee? first of all, on page 9 of our report, on march first, 2016, the sfmta responded that in addition to the 155,000 that supervisor tang i want to emphasize, that is the information that they gave us. when supervisor yee asked that this item be continued, they then told us that there would be another, that it would be $355,000 so i want to clarify that the budget analyst was absolutely correct in the report that was submitted to the committee. so on that march first, as i say, they bumped that up to $375,000, which we think is
correct, because they had not previously told us about the fact that there are costs to move the trains to the sites. and the over time. and so what does that result? >> that means that during the first year of the proposed new lease, sfmta will pay, $2 milli million. on page 10 of the report, advices that one operator training class was cancelled in the 2015, and that all of the remaining 13 classes in 2015,
had to be reschedule or adjusted to fit the training facilities that were available. and when the operating training classes must be pushed to saturdays, the sfmta estimates that this costs sfmta, approximately, 26,000 in over time, and reports that this occurred, 3 times in 2015, and anticipated to occur at least once in 2016. sfmta response notes that the sfm training staff, shortages, not lack of facilities resulted in additional operator, over time, costs, of $920,000 in 2015, 6.9 in 14, and 13 and 12, and notes that if, if, sfmta were to have missed just one
training class with 30 bus operators and based on the existing attrition rate of the 50 operators per month, they would have to misschedule muni service or in crease, operator over time. if one training class of 40 bus operators, cannot be reschedule, sfmta estimate tz would result in more than 400,000 in over time or $5 million of additional over time cost to sfmta. on the bottom of page 10, supervisors, we note that the sfmta, will spend $2 million for the costs in the first year, which is 575 percent more than the 375,000 incurred in 2015, but the training facilities in the related expenses. over all, sfmta will expend, 24.5 million in rent, over the 9 year term, and at the end of
that period, if the city of san francisco does not extend the agreement with the owner on the property to allow a bus operator training facility on this sight, they will find itself in the same situation it as it is, and there will be fewer lease or purpose options at that time, simply, if the sfmta exercises the options to purchase the site, they would expend it minimum of 44.4 million, or 5 million, 44.5 million. including the rental costs and the costs in the property with no guarantee that the site will be used as a long training bus operating facility, that the city may require a different use of the property. supervisors, on the powerpoint presentation the department says
that the average daily service missed and they show, and i want to emphasize that they have not represented that this is because of the training facilities, this is because they missed services as you know because operators maybe sick and call in sick. but because buses are down, because of a lack of maintenance. i also want to note that i, first of all, i appreciate mr. haily's forth right respond to supervisor yee's question. and that he specifically said that there was not one class, not one classes that been cancelled because of a lack of facilities. and i appreciate that honest response.
mr. chairman, members of the committee in conclusion, we are not questioning the desirability of one consolidated training facility. our question is the significant cost increase and the fact that as supervisor tang has pointed out, at the end of 9 and a half years, the sfmta may be back to square one. our recommendation is we recommend that you amend the pro-he posed resolution to 9 years and five months. as stated in the lease. instead of the 9 years and 6 months as stated in the resolution. and we can consider approval of the proposed resolution as amended to be the policy decision for the board of supervisors and we would be happy to respond to any questions. >> okay. >> thank you mr. rose. colleagues any questions right now for the budget analyst? >> okay. why don't we open this up to public comment. item four?
>> thank you, anyone else wish to comment on four? >> seeing none, public comment is closed. >> colleagues, i will open up for anyone's comments, or discussions or motions. i struggle and have struggled with one, i understand the necessity, here and i think that the cost and some of the questions were spot on and our budget analyst report. i think that we have a number of options here. but let's have a dialogue here, supervisor tang? >> thank you. >> so again, this is not an easy one here, but i think that what i would be comfortable with is sending this out without recommendation to the full board and maybe when it is in front of all eleven colleagues, then, perhaps there could be more discussion on it. more questions answered from some of them that may wonder about this cost as well. but just at least move it along
forward and see if you know i don't want us to talk in circles or if there is anything that can be productive and make sure that mta reaches out to all of the supervisors before it gets to the full board. >> okay supervisor yee. >> thank you tang for that position. >> i don't want to hold it up. i am not comfortable, fully support it today. but at the same time i understand that we need to continue this progress on the lease and bring it to the full board and see there is enough support or whether or not at that point may find a better arguments on why i should be supporting it. i will support, or second it. >> okay. >> and let me just suggest that we will go out to the full board without recommendation in the interim, if i would asked to be at every, supervisor office talk and briefing with them to have a vibrant discussion of the full
board and informed and that, as much as possible, staff comes to the full board meeting when we consider it as well. >> okay, motion by supervisor tang, then, and we can take it without objection. >> mr. chairman, would you like to take any action regarding the proposed amendment? >> right, sorry, the motion to vote. >> i amend my motion to accept the budget analyst. >> rescind the vote. >> by supervisor tang and take that without objection. >> and now i make the motion to amend it with the budget, and send it forward without recommendation for the full board. >> tang and now we can take that without objection. >> okay. thanks, everyone, for that item. we have item number five here, there clerk would you call 5. >> ordinance providing that the competitive solicitation process requirement in the administrative code, 21.1, shall not apply to the department of public health's contract for a modern, secure and fully
integrated electronic health record system for the san francisco health network to replace, dph current system and the selection of the reintelligents of the university of california. through the university of california, san francisco. as the preferred contractor and authorizing dph director into negotiations with uc to procure the new ehr system, or enter into negotiations with specified alternate vendors as defined in this ordinance. if negotiations with the uc are unyou can is s unkuk seg /* /- unsuccessful. >> could we hold on for 15 seconds.
>> all right, everybody welcome back from -- okay, everybody, welcome back, >> good morning, director of health and just to state that there are three additional staff members that will be addressing our request today. and as you know we are seeking authority for the next step of our procurement for the electronic health record. the federal government is looking at this and it is important that you will hear about the safety of patients and also about insuring that our physicians also, accept the system that we create and purchase. we have 60, cares, and it works
in the adequate systems and so acquiring the unified, electronic system is the top priority for dph in. and not to say that for the five years that i have been health director the majority has been focused on the it system. we were not prepared four years a ago, and we have a lot for the infrastructure and to be ready for an integrated electronic health record. and the eehr systems as we call those are improve, for the patient's care and safety, you will hear today with 61 distinct systems of applications how can you really serve a person as they are going through the integrated system. it improves the data and research for the better health outcomes and the federal government is not looking at the number of people that we are serving as we used to be funded for, and they are really looking at how well are they doing after your care? and the out comes that we, are
trying to reach, as provided by the federal government. and we are also seeing that with the integrated with the electronic health records that we improved the revenues by a great percentage and we reduce the compliance risk when we know where everyone is in one system, so this is a very costly system for us. and so we really only have one opportunity, at this opportunity. that we are looking to do today. and so, it is really important for us to get this right. and every patient, that is impacted by this, as well as every social worker and every nurse and every physician in terms of providing care, at dph. we have worked at looking at two distinct options, for the approach for unified electronic health record, there are and we do have a great opportunity, unique opportunity, and a partnership to share the use of the existing system at the university of california san francisco. or we could do a selective event
to directly build a new system. and we have determined that ucsf is our best opportunity for a unified, electronic health record and half of the physicians are already on the uc system. and the apex as they call it and part of every research, that you would look at for failed, implementations of these systems are dependent on the ability for the users to really adapt and accept an electronic health record and we believe that using the medical center and the system and bringing that together with dph who has already had seven implementations of this unified, electronic record puts us in a strong are position for the future of our ability to adapt and implement this new system. so today we are looking for permission from the board of supervisors to negotiate with ucsf to contract, for its share
to unified electronic health record. we have one of our leaders in the clinical system and cfo will be making presentations today to the importance of this seeking authority from you. >> thank you. >> and just as i quick question, to confirm, and in my role in the hsf board and a lot of supervisors are spending a great sums updating the systems and this is, and i guess that i am asking you, this is a major push kind of threw out the hospital systems and services systems. >> absolutely, we are on the late train on this. because all of the other systems in our area have already made the decision like this and we are one of the last systems to not have the health record and that is because we are trying to build the network and trying to find the financial pathway for this as well and so important for us to do this as soon as
possible and so that we can compete and meet the obligations and we bring in $600 million of revenue, every year, if you look at that from a 5-year, period of time, that $3 billion of revenue that is dependent on the electronic health record. >> i will be introducing albert who is our director of ambulatory care. >> good afternoon, i am a trained physician, and director of the care and the chief, officer for the health department. you may know this already, san francisco health network is actually dph integrated delivery system in 2013, it is the only complete system in the city, it has an acute hospital, and it long term care facility, and a primary network of mental health and substance abuse clinics throughout the city, and
researches, including, the public health nurse and our trial and analyst, and health program and the nurses and the health at home, who serve, mostly home bond, san franciscans. so this is the problem, the problem is, as an example, when i am seeing my patient, mr. lee, who is actually a patient of mine, and where i see the patients i don't have access to all of his clinical information across the multitude of the systems out in our network. that really presents the significant risks that i could either prescribe a medication, that interacts with another drug that was prescribed by another in the network or missed a diagnosis that was picked up by another provider. or that i missed an abnormal findings that were ordered outside of the primary care network. or failed to follow up on something. so there is significant patient safety risks when the entire set of that patient's information is not available at the point when i am seeing my patient or any of the provider frankly.
>> could i ask you a question on that? >> please. >> i fully understand that. my point of view with my children and my parents. and medical situations, certainly in the last few years, that being said, why can't you? with the two different systems what prevents from having a second terminal. and two screens up at once. >> yeah. so, well, certainly it is about accessing so some of is certain systems are not accessible to me because i don't interact in the mental health system even if i do have access to that, i am not sure if i know how to navigate through a very complex electronic health record system where the filing of the information and the storage and the information the documentation of the content may be structured in a way that i will not be easily to decipher, that is one. and second, the different electronic systems require an enter face and very technical mapping of information and sharing of information.
and as director garcia noted, and bill later will talk about more, we have been spending a lot of effort over the number of years to try to show up the infrastructure to leverage in technology, if you don't have it in place you will not able to use this. those are probably the biggest driver and the third one is over in the last two or three decades, and the network and the department, has really, sort of adopted, patch word solutions to meet the needs of san franciscos and the population that we serve and so we have not approached it in a coordinated unified manner to say let's have one solution regardless of where that patient is, and which provider is, and which part of our system we are seeing all of the information, and real time, and in accessible. >> so we can do that right now.
so what we can, and what we cannot do is see the entire picture at any point in terms of the access to the system. so these, and these are just examples on left side. the director garcia mentioned the 61 systems and touching the different part of the network. so what is an ehr. simply it is a digital record of the patient's information not on paper format. and it provides real time, patient centered record where all of the information is available, securely, and instantly when you need to access it. and it includes the medical problem, the medication list, the diagnosis that is made and the labs and the studies and all of the notes and that is all in
one, repository i want to give you a story, this was a patient that i saw last night. he was referred to me as a behaviorist and a psychiatrist, and one of the mental health clinics in the network and the two there, and recognized that he had a he did not have patient a relationship with any of the primary care physician, and so that was referred to me as a mare care doctor and he had a new condition that warranted more evaluation. so when i saw the gentleman, the only thing that i knew, was, what was recorded in the chief complaint because he did not bring any records and he did not bring his medication bottles when was recorded when the appointment schedule was referral, to established care. so, i inquire you know, how can i help you tonight? and what is, what brought you to the health center? and he said, in a matter of factually, don't you have that
information? i just saw the therapist and the psychiatrist the other day and he referred me to you and he said that you will know what to do for me. >> i was a little bit embarrassed because i didn't have an answer to the question because i did not have access. so i tried to do my best, that night get the information and perform evaluation and i asked to make sure to get the records and ask them to staff the records over. when i reviewed the records and was alarmed that he was recently seen at saint francis and was prescribed a medication that if it was not tie traited well, it could actually lead to very serious, and potential, fatal complications. i toemd my medic aexistent.
now there is a dual process, involving for the two systems to bill for the services. i document my assess m, in one system. and but we bill, for the services out of another electronic, health ehr system. we have some of the information is automated and enter face as you sort of ask, on the chair, farrell and some of the data is enter faced and some of it requires the manual entry, and as you can imagine, that really, processes the potentially not
billing for all of the processes or billing for what we did not enter, or enter it wrong, and so therefore it puts us at a risk. and not to mention, all of the new funding requirements on the out come not just the service from the government. so, why do you ucsf? >> it is really a unique partner to help us to better service the patient and they are not just a vend vendor. they already built, and designed and implemented and the system in across the hospitals in the network. and over has and there is failures and success that you learn from those experiences. we have had 150 a year, partnership, with really, the institution that shared very similar, mission. and that is to provide, quality and compassionate care, to the most vulnerable, citizens and
residents of san francisco. we know from the industry, and from partner, an industry expert in hit, as well as from our prior electronic health record implementation. that the number one biggest driver of success or failure, is physician adoption of that information system. it is not just about efficiency, but it is also cost control. and because all of the physicians and trainings are from ucsf, their knowledge and proficiency, using epic or as they call it apex will be incredibly valuable to us, having more likelihood to succeed in our implementation, and more importantly, there is an opportunity, cost there. which is because they and because the inpatient system, and they are very familiar with. and we can spend our time and re soe resource building out the other
mod youals, and the mental health records and the job health records and the tr transitional records. we will be able to take that resource and start building the other pieces sooner, and faster, so that we don't delay, this coordinated fragmentation, of information. and 78 percent, of all of the patient rerefer, outside of bph goes to ucsf for the services that we don't currently render in the network, that is, you know, that sharing the same instance, actually makes it seamless, because they have the same record when they go up there and simply when they come back to see me, i will know exactly what they did, when that patient returns. and issue, and there is no issue. and obviously throughout the bay area, the majority and i would
say that the majority of the bay area, health systems are already on epic and it gives us the information to share the information and exchange data cross the systems to learn at a population level, how do identify the needs and the gaps of the vulnerable population and how to create the service to better serve them. and lastly, both organizations are committed to the local business enterprising and training opportunities to increase a diverse workforce. at this point, i am going to transition to bill. >> good morning. i would like to give you a background on how we got here today. so, as you may be aware, last year, dph submitted, to dpehr replacement project. it was a very high level, estimate. one thing that i do want to know, unlike most struggled ehr
effort, this effort is actually not an it initiative, but one of business. so if you go back several years, dph, focused on improving dph effectiveness to better protect, health of san francisco in a post, high-tech, world. engaged several experts in the field and not only in healthcare but also in it. now, what came out of that was, that they needed to improve the capabilities in order to better super dph so that it will provide better support and care for san franciscans, and specifically this meant that it capabilities had to be improved, in people, process and tools. so, we have in the last two
years, hired 71 positions, and we continue to hire more. these people will be, these are city employees who will be not only be supporting ongoing operational functions, but also free up, the exist an subject, matter experts to help us build a new system. now, in addition to that, we have implemented a new it, industry level, and best practices and framework for the it process. the reason why, i bring these two up, is because, in order for any ehr effort which are in a large dollar amount to be successful, you have to have the foundation to succeed. in terms of the infrastructure, with the help of our local businesses, and obs, we are now implementing that medical grade fully, functioning high capacity high performance, insfra
structure across dph throughout san francisco and we expect to that have in place, before the go live of this ehr. that brings us to the last piece. the last piece that we are here to talk about which is the ehr. our foundations are finally getting there. we now need the tools to do this. and now, the reason why i am here, is to actually echo what actually has been and learned by many of the organizations which is that you can spend hundreds of millions of dollars and still fail, if, you fail to actually use the system. what happens typically and the failed implementation is not the technical aspect and i hear as a cio will tell you that it is actually pretty simple. what is hard, is reworking the processes. and understanding what needs to be done and who does it. training your physicians, and the nurses, and everyone to use the system effectively. and this will not only have an impact on our budget, and the
over all project budget, but it will also have the patient safety impact, but more importantly, this will have revenue impact. you could look, at many articles on the internet these days about failed implementations and they will tell you, the implementation was great. but because they could not use it, they are not receiving the money that they were seeing prior to the implementation. >> i believe because the physicians are using the system that we are proposing to contract it, and that we will mitigate, the most significant risk to the largest indid he ever that we are taking in the city. and now, interesting enough, after all of the discussions and all of the explorations that we did, we actually came to the same place that the federal department of health and human
services and industry, analysts showed only two leading ehrs and it is true that there are two that could help us, but i have to really, focus, on the fact that we are not buying a system that are identical to each other and what we are really getting is a value add that the physician, population who already know, how tho drive the system. we do not have to take risk, where it is not needed. thank you. >> greg and i am the last one in the string here. so, on the cost of the system, this is a very major undertaking. it is a multi year effort and supervisor, farrell as you alluded to, this is something that the health systems across the bay area and the state and the country are doing. they are large, and cost and
investments but they are, viewed nowadays, as kind of the center piece of a health system's ability to provide care. we don't have a final cost, since what we are asking for you today, is simply permission to enter into negotiations. we do have an estimate, that we have developed, to give you a sense of where that is headed. and we estimate a ten year, net cost of 181 million dollars and that includes, the cost increases offset by savings that we would have for the retiring existing systems and the operational, savings. i want to point out that that cost is a large cost, but that is not just the cost of buying software, and bill alluded to this. that the actual purchase of the license, of the product is a relatively small fraction of that cost. a lot of the cost involves that the development of our internal infrastructure and put the
processes in place, and training our staff, and getting our work flows aligned internally. and our billing infrastructure, set up. and so what we are really, including in this figure, that we are showing you, is not a piece of software, and it is a program that will occur over the multiple years that really kind of changes the way that we are operating our healthcare delivery system. so, we --. >> real quick, what is the break down between that then? >> the actual cost of just the license itself, is about -- 22 million. of that $181. >> got it. thanks. >> so, in terms of the financing plan you have seen, some of this in the budget that was approved for the current two year budget for 15, 16, 17, and you will see more in the coming budget, and we have a financing approach that includes, a variety of sources, that is existing
appropriations again, that are already in base budget, after last year's process. and we have hospital revenues, that will continue, or contribute to the funding of this system. and this has been our top priority in the budget process, and so we really focused on reallocating the resources from within the department and towards this he v effort and you will see that in our budget in june and lastly we do believe that there is an opportunity to get, support as we have recently for the other initiatives by the virtue of the fact that this is an innovative partnership model, where we are bringing in the two systems together and the san francisco general hospital, foundation, has indicated that they are interested in this as a potential source for donations, and that they are willing to work with us to help us see what we can do to offset the costs.
lastly, is barbara mentioned, this is not only our clinical care system, this is our core building system. so all of those clinical records, get translated into bills, that are submitted to medicare and private insurance, and we use those to support a very large amount of revenue throughout the network. and so this is in addition to being clinical and a priority and it is a very, significant financial priority, for the department to maintain the financial health over the coming years. so, again, here is a very brief summary of the estimated costs and sources. we have about 68 million dollars that is appropriate ated to date, and you will be seeing another roughly, 17 million dollars, that we have balanced around, within our budget instruction targets, in the budget submission, coming to you
in june. and we will still have some work to do to finalize that funding package. as we go forward, over the coming years. but we have the core of the financing plan in place. through the budget in our financial plan that we are submitting. >> so, again, just to kind of summarize where we are. and the ordinance, that we have before you today, is requesting that based on the benefits that we believe that we can receive in terms of clinical, patient safety and patient care, better data for medical research, and population, health research, and we think that those are benefits that are achievable, by virtue of the partnership with the ucsf and that if we leverage that and we can get a benefit for our patients that we cannot get in any other way. it is not simply, selecting and we have vendor, and we are saying that we want to pick one
of them. we are saying that we want to go a different approach and then turn to a public, sector partnership that we think ko do unique and that is why we brought this ordinance to you today. to request your authority to enter into negotiations with ucsf. to see if we can make this agreement work, and enter into a partnership and the authority is limited to this project only. and if we are able to negotiate, in an agreement, and that will return to the board of supervisors for approval prior to anything happening. and so we are really asking for today, is for not to approve a contract, is to enter into the process of trying to negotiate a contract. >> we are happy to answer any of the questions that you have. >> thank you. just to confirm, if we were to go forward today, whenever the contract would be up it would be back before the budget and finance committee and the full board. >> absolutely and that is
specified in the ordinance. >> i am sure that my colleagues have questions. i guess the one natural one is to say, okay. if it is a 181, let's leave the integrated discussion for the for the patients, which i think that is critically important and leave that off of the table. and i understand everything. but on a pure financial buy sis, 181, over ten or nine years, 20 million a year here. which includes, capitol and operations for the system. what would it be i mean it is hard to say, what anticipate and the existing costs are $10 million a year. with the existing vendor, that will continue to escalate or how would you assess that? >> yeah, so, in the model that we have that will escalate. we have an issue ch the existing system and it is especially our hospital, inpatient and our billing system for the hospital
and primary care, is coming to the end of its usefulness. we are still using it. but, it is out dated. so, it is not a long term viable solution. we have assumed in the numbers that we have given you is that we have just taken that 10 million and said that goes away so that we will apply to offset against the cost. in addition we have assumed some savings verses the 5 year, financial plan, in our costs that are anticipated particularly in the physician, provider contract where we believe and our ucsf h, believes that if we are able to implement this system, it will result in additional billing for them for the professional services and the operations and that will reduce the cost to the department to purchase its physician services. >> there are two those. >> thanks. >> supervisor yee? >> i think that you made a
comment that the numbers that you are giving me is sort of a guess or an estimate. and what guarantee do we have if you do go, and negotiate with ukr. sf for them to say, wow, where we are only, going to be able to do this. and come back with a contract that is actually going to be substantially more than what you had estimated? is there any? >> way to sort of prevent that? >> absolutely. that is a good question. supervisor. so a couple of issues, are, we are asking the authority to negotiate, but we always have a plan b for ourselves. we do have financial constraints, and we know that the city has financial constraints and that is at the top of my mind. and so we are going to go into this and attempt to negotiate something that we can afford and that works technically and
operationally. if we can't, we always have a plan b for yourselves, our plan b would be that if we can't make that work, then we will go to a different option and one of the criterias is going to be if we can negotiate a contract that we can afford. and so, there is no assurance that we will be able to negotiate it. but, there is an assurance that if there is a contract that we cannot afford within our financial plans, we would not be able to bring it back, and to say that we have the dollars to front it, and again, that contract would come back for the board of supervisors budget analyst for approval, if we are able to complete negotiations. >> i know that you are in the odd situation, once you put the numbers out, it is almost, a guarantee, that the contract will not be any less than this. since you are saying to them that is how much that you have. >> you know, we i think that you are right. you know we wanted to put some
numbers out so that you have a sense in your oversight role of what we are looking at, but, these number are not magical and we are going to negotiate and we are going to go into detail into what the costs are. and we have done a solicitation for vendor support to assist us in negotiation and go through and do a review. of what is proposed in the contract. from an independent third party. perspective. and to advise us on what the deals usually look like, when we were made out in the larger world. so we will have some advice, and set the support for ourselves to identify where we are, and are not getting a good deal. and we said that there is a little bit of that dynamic, but we will be committed to getting the best deal that we can for our department and we need to do that for the financial viability
as well as the city's. >> and in regards to the means benefit, estimates or, you know, to the cost savings, can you, what is causing the spike from your 2017, to 2018? or the other way? 10 million to 24 million? >> oh, in the budget analyst report. okay so there are a couple of different elements that are included in those savings. so that the ten million dollars, is our existing cost for certain contracts that we will be able to retire under once we replaced that system and so we would no longer have to run the systems it is a fairly conservative number. the other aspect of this is if you would look at our history and the city's five year, financial forecast, we for, the
physician services at san francisco, general hospital we use the school of medicine physicians and residents to provide those services and we paid for them for the services that they are not reimbursed through. as we have gone into this, if we have a system that is able to optimize our operating*- we will
be able to retire those systems and our contracts and so that is our hospital, and inpatient and billing system, it is our ambulatory care and our primary care and ehr that is in the primary care and other supporting products that we are purchasing and so both the new cost. >> and so that i think my point, really is, right now you have a net total cost of 181 million. i am just thinking, that what you have not incorporated in through the city is not really a
savings, but you would have to come up with it a new system that is going to cost you money. so, it is not truly, 181 million that you have to spend the extra. because you would have to spend the money to have the new system. >> absolutely. >> and that the cost of that new system is on the cost side, so you will see that there is added cost of 340 million and partially offset and so it is a net cost to us that we have been working on applying for. thank you. >> supervisor, tang? >> thank you very much for the explanation and i think that again, it is very clear the need for a new system, and one that is clearly a lot more integrated. since the item before us is about waving a competitive so listation process, i was wondering that there have been concerns about not going forward with the rfp process and could you talk about why dph decided or is bringing north this item.
>> sure. >> thank you for the question. and i do want to say, we understand that and we get the benefits of an rfp and i have never asked for this type of permission before i don't expect to, again. but it really is because of the unique nature of this situation that we are in. so i think that the way that we are really thinking about it is, this is not a situation where you have vendors that can provide you a product that all can kind of do it and you are going out, and looking for the best cost for a similar product or the best quality. that is part of what is out there. and that could be where we end up at some point. but what we are really doing proposing here, and the way that we are looking at this, is this is kind of a different route, instead of just buying a product from a vendor, we are proposing to say, let's take a different approach and go with a
government to government agreement where we are leveraging both their system and their operations. and the reason that we are doing that, is because we have kind of come to realize, that by virtue of that partnership, and not by virtue of what the software is or what the system is, it is the partnership itself, that we can do something good for our patient and that we can contribute to the medical research, and the popular, health management of the city and since it is by virtue of the partnership itself, there is by definition, not really another path that we can take to achieve those benefits for a patient population, so you kind of have an apples to oranges situation where there is really only one path that we can take that gets us all of those things that we see that are available to us. and so, seeing that, in front of us, if you are doing an rfp process where you are comparing apples to oranges, you kind of
have a strange situation where you are either focusing our rfp just to capture those things and you can only get in one place, or you are putting yourself at risk for getting something that will be less than opt mal for your patients. and so seeing that situation, we determined that we wanted to come bring this to the board. and say here is what we see, we think that there is a unique opportunity to do things in a different way that will have real benefits for health system, and seek your support to pursue that alternative. if we did not, or if we were not able to achieve what we opened that we will be able to achieve with the ucsf whether for the financial reasons or the technical reasons or whatever it will be, i think that we will be back in a more standard place, where we will be building our own system and it will be more of a scenario where we are saying, that we need our system, which is the best product for us
to go out and purchase. >> so i think that i get that, distinction and so, what if, and let's just say that you were to do an rfp, would that also be the process or the place for you to explore, whether this partnership, would work out? >> well, it is a good question. and i think that there are a couple of concerns that we have about that route. we did think about this. and evaluate it. the first is, that we are again, proposing to negotiate with ucsf, they have a system that they have bought from a vendor, but our negotiations and ultimately our agreement would be with ucsf and not a vendor, so there is not a precedent that i am aware of for the governmental entity to bid and compete through an rfp process
of this nature, ucsf bids on the patient, community care contracts with us, but those are service contracts. this is unchartered territory of how the government to government, partnership will work, the second issue is if we were to go through a process of your standard rfp process, what does that look like? we want a vendor that will, be or provider of care and especially services for the population that trains our figureses. and if we did, and there will really only be one respondent and cap able. and meeting those criteria, if we don't include those and then we don't capture those benefits in our evaluation. and so that was our logic and
our thinking on why, because this is such a unique, situation, it does not lend itself to the normal process that is -- >> thank you. >> okay. if no other questions fl rose could we go to your report, please? >> yes, mr. chairman. the members of the committee, on page 17 of our report we note that the actual projected expenditures from july, first 2010, to june, 30, under the existing contract, the electronic healthcare system, between dph, is 52.3 million, and that is shown on table one, and again, on page, 176 our report. and the board of supervisors has appropriate ated the general fund moneys for the existing contract. we also know that as shown in table two on page 17, of our report, dph